A groundbreaking study has uncovered a stark disparity in the administration of life-saving antenatal treatments for premature babies worldwide. The research, led by the University of Bristol, analyzed neonatal data from over 300,000 premature births across ten countries, revealing significant variations in the use of magnesium sulfate (MgSO4) and antenatal corticosteroids (ANS).
Premature babies born before 30 weeks of gestation face a higher risk of severe health complications, including cerebral palsy and respiratory issues. Magnesium sulfate, a cost-effective treatment, significantly reduces the risk of cerebral palsy when administered to mothers before preterm birth. Similarly, antenatal corticosteroids mature the baby's lungs, improving their chances of survival.
Despite global clinical guidelines recommending these treatments, the study highlights alarming disparities in their administration. The research, published in the International Journal of Obstetrics & Gynaecology, found that countries like Ireland and the UK had high administration rates of MgSO4 (over 80%), while South Africa and the UAE had much lower rates (33.6% and 44.5%, respectively). In contrast, ANS was used more consistently across countries.
The study also uncovered significant income-related disparities. Higher-income countries averaged 74.8% MgSO4 implementation, compared to just 49.4% in middle-income countries. This equity gap has not narrowed over time, according to the supplementary review, which found treatment rates similar to those in the VON cohort.
The study concludes that there is considerable variation in the use of these interventions globally, with much lower uptake in middle-income countries. It calls for further research to understand the reasons for these disparities and to improve the global equity of these essential antenatal treatments.
Hannah Edwards, a Senior Research Associate at the University of Bristol, emphasizes the importance of international collaboration to achieve health equity for mothers and babies worldwide. She highlights successful implementation programs like PReCePT, which has transformed the use of magnesium sulfate in preterm births in England, and emphasizes the need to ensure that all babies, regardless of their birthplace, have access to evidence-based treatments that offer the best start in life.
Karen Luyt, PReCePT's national clinical lead and Professor of Neonatal Medicine at the University of Bristol, underscores the power of international collaboration in achieving health equity. She believes that the PReCePT blueprint for successful MgSO4 implementation will be valuable for accelerating its use in routine clinical practice across international healthcare systems.
